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Early detection messages failing to halt deaths from UK’s most common cancer

Two studies due to be presented at the World Congress on Cancers of the Skin in Edinburgh, Scotland, this week, show an increase in advanced-stage skin cancers, highlighting an urgent need to publicise self-check and early detection messages.

Skin cancer is the UK’s most common cancer. Melanoma is the most dangerous form of the disease, and is relatively unique in that it is a highly visible cancer, allowing people to monitor their skin for changes themselves. As with most cancers, early detection improves the chances of survival.Melanoma tumours grow in ‘thickness’ (depth of invasion into the skin) the longer they are left untreated. The ‘Breslow thickness’ of a melanoma lesion, measured in millimetres, is used to assess how advanced it is and has five stages, ranging from the cancer cells only being in the outermost  layer of the skin, to the tumour being more than 4mm thick.*

The first study looked at 1,769 melanoma patients seen at the St. John’s Institute of Dermatology at Guy’s and St. Thomas’ Hospitals in London between 1999 and 2012. They found that the incidence of melanoma increased by 76 per cent during the 13-year period. The Breslow thickness of the melanomas increased across all demographic groups, from a mean of 2.25mm to 2.43 mm. 

As the data for thin, early stage tumours was excluded from this study, the results suggest that the overall increase in melanomas being diagnosed is, at least in part, due to more advanced cancers which have a much poorer survival, rather than a surge of early-stage tumours in response to greater awareness of the disease. 

Study author Dr Wisam Alwan said: “Our data shows an increase in the number of cases of melanoma seen across all stages of disease, including more advanced tumours, with no improvement in survival seen during the study period. 

“The number of people dying from melanoma is increasing year on year and this emphasises the necessity of early detection of tumours, given the poor outcomes associated with advanced disease. Strategies that tackle both the prevention of the disease, and that encourage people to seek help earlier, are crucial.”

The second study, from Barts Health NHS Trust in London, reviewed 92 cases of melanoma seen in the region over one year. 16 per cent (15 cases) of ‘thick malignant melanoma’, in which the tumour was greater than 3.5mm and therefore more advanced and harder to treat, were identified. The mean Breslow thickness in this group was 6.4mm, the thickest of the five stages on the Breslow scale (more than 4mm).

Despite the tumour size, 40 per cent of these patients had noticed a changing lesion for at least four months before seeking advice. Interestingly, most (73%) were a type of melanoma called ‘nodular melanoma’ and the authors speculate that current early detection messaging, using the ABCD acronym** (which stands for Asymmetry, Border, Colour and Diameter – the key areas of change to look out for), may not be as applicable to this type of the disease as to other subtypes.

Dr Andrew Lock, one of the study’s authors, said: “It has been suggested that nodular melanomas behave biologically differently from other subtypes, and the ABCD criteria to aid diagnosis may indeed lead to late presentation. Perhaps the latter is applicable mainly to the superficial spreading subtype, which is the more common type of melanoma.

“Our study reinforces the observation that the incidence of thick melanomas is not decreasing. New strategies and education programmes are therefore required for the earlier detection of such tumours.”

Nina Goad of the British Association of Dermatologists said:  “The majority of public education campaigns around skin cancer have focussed on preventing the disease, by staying safe in the sun. What these studies show is that we now also need to target our efforts on early detection, by encouraging people to check their skin and report anything suspicious to their GP sooner rather than later.

“We’ve been doing this for some years with our Be Sun Aware Roadshow, where we take mole-checking to high profile venues, and we are now trying to target the people we know tend to present late with skin cancer, which tends to be older men.

“However, the studies raise an interesting point about the different melanoma subtypes. Nodular melanomas, which accounted for the majority of melanomas in the review by Barts Health NHS Trust, are less common than the ‘superficial spreading’ type of melanoma, to which the ABCD rules apply. Their rate of growth is usually faster and unfortunately they are also harder to diagnose clinically. They become life threatening quickly and can mimic other, less harmful skin cancers and benign skin lesions. This makes public messaging for these cancers tricky, and something we are going to need to think about if we want to reduce our melanoma mortality.”

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Notes to editors:

*More information on melanoma staging and the Breslow thickness scale can be found at:http://www.bad.org.uk/library-media/documents/Melanoma%20-%20Diagnosis%20and%20Staging.pdf

** There are three types of skin cancer, and all look different. The following ABCD-Easy rules show you a few changes that might indicate a 'melanoma', which is the deadliest form of skin cancer.As skin cancers vary, you should tell your doctor about any changes to your skin, even if they are not similar to those mentioned here.Remember - if in doubt, check it out! If your GP is concerned about your skin, make sure you see a Consultant Dermatologist, the most expert person to diagnose a skin cancer. Your GP can refer you via the NHS.

Asymmetry - the two halves of the area may differ in shape
Border - the edges of the area may be irregular or blurred, and sometimes show notches
Colour - this may be uneven. Different shades of black, brown and pink may be seen
Diameter - most melanomas are at least 6mm in diameter. Report any change in size, shape or diameter to your doctor
Expert - if in doubt, check it out! If your GP is concerned about your skin, make sure you see a Consultant Dermatologist, the most expert person to diagnose a skin cancer. Your GP can refer you via the NHS

For more information please contact: Matt Gass, Communications Officer, on 020 7391 6084 or atmatthew.gass@bad.org.uk

If using this study, please ensure you mention that the study was released at the World Congress on Cancers of the Skin. 

The conference will be held in Edinburgh from September 3rd to 6th 2014, and is attended by approximately 1,000 UK and worldwide health professionals.

The World Congress on Cancers of the Skin 2014 was founded by The Skin Cancer Foundation, the international organization devoted solely to education, prevention, early detection, and prompt treatment of the world’s most common cancer. It is organised by the British Association of Dermatologists.

Study details:

042, Epidemiological trends in Malignant Melanoma in a large urban population in England from 1999-2012; Wisam Alwan1, Panos Karagiannis2, George Poulos2, Katie Lacy2

1University Hospital Lewisham, Lewisham and Greenwich NHS Trust, London, UK, 2St. John's Institute of Dermatology, Guy's and St. Thomas' Hospitals NHS Foundation Trust, London, UK

Analysis of trends in stage, site, 5-year survival and mortality from malignant melanoma in a patient population referred to a tertiary referral centre based in a centralized urban location.

Retrospective study of 1769 cases (913 male, 856 female) referred to our unit from 1999-2012 through analysis of our local melanoma database, electronic patient records and case note review. Cases of cutaneous malignant melanoma of histopathological stage IB and above according to the American Joint Committee on Cancer (AJCC) criteria[1] were included, with a smaller local cohort of 235 patients for which all stages of melanoma were recorded.  Data on incidence, mortality, Breslow Thickness, body site and disease stage were analysed.

Mean age of diagnosis was 58 years for all patients during the study interval (mean age for males 60, females 56). Incidence of melanoma (Stage IB and above) increased 1.7-fold from 3.28 to 5.77 per 105 of the population from 1999 to 2012 in line with national trends.

Breslow Thickness increased over the study period for the entire database population from a mean of 2.25mm in 1999-2000 to 2.43 mm in 2011-2012.   The trunk was the commonest body site affected in males (36%) and lower limbs in females (36%).  No significant differences were observed in stage of disease at presentation for different body sites.

Mortality rate (melanoma-specific deaths) also increased, with a rate of 1.96 per 105 in 2011-2012, compared to 0.10 per 105 at the outset of the study, with men having the poorest outcomes (2.24 per 105 in contrast to 1.70 per 105for females).

5-year melanoma-specific survival figures were 96%, 85%, 78% and 32% for stage I-IV disease respectively; consistent with published data[1].

Malignant Melanoma continues to rise in incidence and is associated with significant mortality.  Primary prevention strategies to reduce disease incidence and delayed presentation are crucial.   The rising mortality rate highlights the necessity of early detection of tumours given the poor outcomes associated with advanced disease.   No improvement in survival was seen during our study however we hope that the new targeted and immunomodulatory therapies will result in improved future survival rates in our patient population.

 References

[1] Balch CM, Gershenwald JE, Soong SJ, et al.  Final version of 2009 AJCC melanoma staging and classification.  (J Clin Onc. 2009.20;27(36):6199-206)

 

043, Thick melanomas: A persistent problem; Andrew Lock, Nilukshi Wijesuriya, Rino Cerio

Barts Health NHS Trust, London, UK

Cutaneous melanoma remains on the increase in Europe, but recently has stabilised. Many recent studies have shown an increase in detection of melanomas <1mm probably due to earlier diagnosis. However, the incidence of thick malignant melanomas (TMM) seems to have remained at least constant (Tejera-Vaquerizo A, Mendiola-Fernández M, Fernández-Orland A, et al. Thick melanoma: the problem continues. J Eur Acad Dermatol Venereol 2008; 22:575-9; Murray CS, Stockton DL and Doherty VR. Thick melanoma: the challenge persists. Br J Dermatol 2005; 152:104-9).

Our skin cancer multidisciplinary team (SMDT) meeting serves a region with a population of approximately 1.7 million. We manage over 200 new cutaneous melanomas per year. We reviewed our primary cutaneous melanomas over a 12 month period, specifically those with a breslow thickness ≥ 3.5mm, aiming to identify important associations or demographic factors associated with TMM.

15 cases of TMM were identified. Of these, 9 were females and 6 males. 13 of the 15 (87%) were aged over 60 years and most patients were of white ethnicity. 11 of the 15 (73%) melanomas were of nodular subtype and breslow thickness ranged from 3.5mm to 15mm (mean 6.4mm). Of the cases, 7 were ulcerated (47%) with a mean dermal mitotic count of 9 per mm2 (range 1-27 per mm2). Pre-existing naevus was seen in none and lymphovascular spread was present in 2/15 (13%). Despite the size, 6/15 (40%) patients had noticed a changing lesion for at least 4 months before seeking advice. Most (67%) cases of TMM identified were in caucasian patients ≥ 60, and were of nodular subtype. Body site was variable and included most sites, including the ankle.

It may be that nodular melanomas behave biologically differently from other subtypes, and the ABCD criteria to aid diagnosis may indeed lead to late presentation. Perhaps the latter is applicable mainly to the superficial spreading subtype.

Our study reinforces the observation that the incidence of TMM is not decreasing. In this group sex difference was minimal. The reason for our findings remains unclear and is multifactorial. However, new strategies and education programmes are, therefore, required for the earlier detection of such tumours to reduce its incidence in these patients.

 

About the BAD

 

The British Association of Dermatologists (BAD) is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease. The BAD provides free patient information on skin diseases and runs a number of high profile campaigns, including Sun Awareness, which runs from May to September annually and includes national Sun Awareness Week in May. Website: www.bad.org.uk/sunawareness

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Moles on the skin increase skin cancer risk

Having moles on your skin can quadruple your risk of developing the deadliest type of skin cancer, according to a study due to be presented at the World Congress on Cancers of the Skin in Edinburgh, Scotland, today.

‘Melanocytic naevi’ are more commonly known as ‘moles’. The word ‘melanocytic’ means that they are made up of the cells, melanocytes, which produce the dark pigment, melanin, that gives the skin its colour. Melanocytes clustered together form naevi. In other words, moles are generally harmless groups of melanocytes. However, the deadliest type of skin cancer, called melanoma, is linked to moles, and approximately half of melanomas develop in pre-existing moles.

This study, from the University of Oxford, UK, and Epworth Hospital in Melbourne, Australia, sought to establish the level of subsequent melanoma risk in people with a hospital record of moles. The researchers compared the medical records of two groups of people – 271,656 for whom moles had been recorded during a hospital visit for any condition, and 10,130,417 people who did not have moles recorded.  Anyone who had been diagnosed with melanoma, either previously or at the time the moles were recorded, was excluded from the study.

Comparison of the two cohorts revealed that over all, the group with moles were approximately 4.6 times more likely to develop melanoma than the group with no recorded moles. Significant risk increases were present when moles and subsequent melanoma occurred at the same site on the body, as well as when they occurred at different sites. For example, moles on the trunk were associated with an increased risk of both melanoma on the trunk and melanoma elsewhere. However the increase was greater when the mole was at the same site as the melanoma – people with moles on their trunk were nine times more likely to develop melanoma on the trunk, and 5.6 times more likely to develop melanoma elsewhere on the body. 

Study author Dr Eugene Ong, of the Nuffield Department of Population Health, University of Oxford,   said: “Our results show that patients with a hospital diagnosis of melanocytic naevi, or moles, have a high risk of developing melanoma both around the site of the mole and elsewhere on the body. These people might, therefore, benefit from increased surveillance.

“Unfortunately we were unable to distinguish between different types of moles or to ascertain the number of moles in each patient.  Our patients were in hospital or in day-case care when their moles were recorded, and so the patients in our cohort are likely to have presented with unusual appearances in the moles, in order for them to have warranted recording.  A mole or moles were the principal reason for hospital contact for 91 per cent of patients in that cohort. So while this study does not suggest that everyone with a single mole is far more likely to develop melanoma, it does illustrate the link between moles and skin cancer. This is why it is vital people check their moles regularly and report any changes to their doctor.”

Nina Goad of the British Association of Dermatologists said:  “When melanoma develops in a pre-existing mole, there is usually an area of colour change, and it is the distinction in colour from the remainder of the mole that is a clue that it might be harmful. Or the mole might be changing in another way, such as growing. If a mole changes in size, shape or colour, or a new mole develops in an adult, then it is best to see your GP.”

Melanoma is the least common but most serious type of skin cancer. In the UK, 6,853 new cases were diagnosed in women and 6,495 in men in 2012. Over the last 30 years, incidence rates of melanoma in Britain have increased more rapidly than any of the top ten cancers in both men and women, and there is no sign of plateauing. Prevalence in men increased around five-fold while in women, rates more than tripled between 1980 and 2009.*

-Ends-

Notes to editors:

More information on melanoma and skin cancers can be found at http://www.bad.org.uk/for-the-public/skin-cancer

*British Association of Dermatologists, Cancer Research UK, Doctors.net.uk: Skin cancer Recognition Toolkit.

For more information please contact: Matt Gass, Communications Officer, on 020 7391 6084 or at matthew.gass@bad.org.uk

If using this study, please ensure you mention that the study was released at the World Congress on Cancers of the Skin. 

The conference will be held in Edinburgh from September 3rd to 6th 2014, and is attended by approximately 1,000 UK and worldwide health professionals.

The World Congress on Cancers of the Skin 2014 was founded by The Skin Cancer Foundation, the international organization devoted solely to education, prevention, early detection, and prompt treatment of the world’s most common cancer. It is organised by the British Association of Dermatologists.

 

 

Study details:

Risk of subsequent malignant melanoma in patients with melanocytic naevus in England: a national record-linkage study; Eugene Ong1, Raph Goldacre1, Rodney Sinclair2, Michael Goldacre1

1Nuffield Department of Population Health, University of Oxford, Oxford, UK, 2Epworth Hospital, Department of Dermatology, Melbourne, Australia

High numbers of melanocytic naevi (MN) or dysplastic (atypical) MN have consistently been shown to be important and strong risk factors for the development of melanoma. We aimed to further characterize the risk of melanoma in those with a melanocytic naevus, using linked hospital and mortality records covering the whole population of England from 1999 to 2011. We constructed two cohorts: one that comprised people with a hospital or day-case record of MN (271,656 people) and a control cohort comprising people without (10,130,417 people).  Anyone with a melanoma on the same record as MN, or one prior to it, was not admitted to either cohort.  We "followed up" these two cohorts to determine observed and expected numbers of people in each cohort diagnosed with subsequent melanoma and calculated rate ratios (RR), based on person-years at risk, standardized by age, sex, year of first admission, Region, and quintile of socio-economic deprivation score. We excluded people diagnosed with melanoma within 1 year of cohort entry to reduce any biasing effects of misdiagnosis. Comparing the MN cohort relative to the non-MN cohort, the overall RR was 4.68 (95% CI 4.39-4.98).  RRs were significantly high across all age groups (<25 year olds RR 3.79 (2.82-5.03); 25-59 year olds RR 5.02 (4.62-5.45); 60+ year olds RR 4.68 (4.19-5.21)). Significantly increased RRs were found for both males (RR 5.92, 5.36-6.53) and females (RR 4.13, 3.81-4.48). We found RRs to be increased across all anatomical sites.  Significant increases were present when MN and subsequent melanoma occurred at the same site as well as when they occurred at different sites.  RRs were consistently higher when considering same-site associations.  For example, MN on the trunk was associated with an increased risk of both melanoma on the trunk (RR 8.99, 95% CI 7.69-10.46) and melanoma elsewhere (RR 5.66, 4.97-6.42). We were unable to distinguish between different types of MN or to ascertain the number of MN in each patient.  Our patients were in hospital or in day-case care when MN was recorded, and so the patients in our cohort are likely to have presented with atypical MN appearances.  MN was the "principal" reason for hospital contact for 91% of patients in the MN cohort.  Our results show that patients with a hospital diagnosis of MN have a high risk of developing melanoma both around the MN site and elsewhere in the body, and might, therefore, benefit from increased surveillance.

About the BAD

 

The British Association of Dermatologists (BAD) is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease. The BAD provides free patient information on skin diseases and runs a number of high profile campaigns, including Sun Awareness, which runs from May to September annually and includes national Sun Awareness Week in May. Website: www.bad.org.uk/sunawareness

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One in ten doctors admit to using sunbeds

A recent study, presented by researchers at the World Congress of Cancers of the Skin in Scotland, has shown that many British doctors take part in activities that put them at an increased risk of developing skin cancer.

The researchers, from Sandwell and West Midlands Hospitals NHS Trust, Birmingham and North Cumbria University Hospitals NHS Trust, Carlisle, advocate that sun safety advice be made more widely available to medical professionals.

The study showed that a third of doctors demonstrated sun-seeking behaviours, such as sunbathing and tanning. 10 per cent of respondents admitted to using sunbeds, despite the fact that the link between skin cancer and sunbeds has been well documented. In 2009 the International Agency for Research on Cancer (IARC), part of the World Health Organisation, classified sunbeds as a Group 1 carcinogen (carcinogenic to humans), the same classification as given to tobacco.

The study reflected similar trends that previous research1 has revealed amongst the general public, in that female doctors reported more frequent sun-protective behaviours compared to their male colleagues. Despite their caution though, women were more likely to have more than one incidence of sunburn a year than men.

The study revealed that only one in three doctors has performed self examination of their skin in the last 12 months, despite recommendations from the British Association of Dermatologists (BAD) to check skin monthly. Interestingly, a similar survey conducted by the BAD in 2013 showed that ordinary members of the public check their skin more frequently, with 43 per cent of the general public compared with 65 per cent of doctors responding that they have not examined their skin for signs for skin cancer.

Dr Jingyuan Xu, one of the researchers from Sandwell and West Midlands Hospitals NHS Trust, said: “The attitudes and behaviours of doctors don’t just impact on their own wellbeing, but can have an influence on how these messages are relayed to patients and the wider public. It’s very important that people are aware that ultraviolet radiation from the sun increases the risk of skin cancer, and that they understand the benefits of enjoying the sun safely.

“It is worrying that a large number of doctors are not looking after their skin in the sun, and only a third of them are checking their skin for cancer. This is a fairly simple thing to do and can make all the difference when it comes to catching potential skin cancers early.”

Matthew Gass of the British Association of Dermatologists said: “Most people enjoy spending time in the sun to one degree or another. However, it’s important to enjoy the sun responsibly, taking necessary precautions and avoiding getting sunburnt.

“It’s disappointing that some doctors are not following the advice that they should be passing on to others. Particularly worrying is the fact that 10 per cent of those questioned admitted to using sunbeds. We would hope by now that most doctors would recognise that if you are looking to get a tan, it’s much safer to get it from a bottle.

“It would be very interesting to see further studies in this area, with a larger sample size.”

Skin cancer is the most common form of cancer in the UK. Melanoma is the most deadly form of skin cancer, with 13,348 people in the UK being diagnosed in 2011 and 2,209 deaths in the same year.

The study invited doctors from a range of specialities and training grades to answer an anonymous questionnaire, which resulted in 163 responses.

1 Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr, accessed on 24 January 2014

-Ends-

Notes to editors:

For more information please contact: Matt Gass, Communications Officer, on 020 7391 6084 or at matthew.gass@bad.org.uk

If using this study, please ensure you mention that the study was released at the World Congress on Cancers of the Skin. 

The conference will be held in Edinburgh from September 3rd to 6th 2014, and is attended by approximately 1,000 UK and worldwide health professionals.

The World Congress on Cancers of the Skin 2014 was founded by The Skin Cancer Foundation, the international organization devoted solely to education, prevention, early detection, and prompt treatment of the world’s most common cancer. It is organised by the British Association of Dermatologists.

 

Study details:

Evaluation of sun exposure behaviour and use of sun protection among medical professionals.

Jingyuan Xu1, Kim Varma2

1Sandwell and West Midlands Hospitals NHS Trust, Birmingham, UK, 2North Cumbria University Hospitals NHS Trust, Carlisle, UK

Excess exposure to ultraviolet radiation has been identified as the most important modifiable risk factor for skin cancer. Physicians' individual attitudes and behaviour will not only impact personal wellbeing but also influence promotion of sun protection to others.

The study aims to look at the behaviours concerning sun exposure and its prevention among doctors across various specialties in the United Kingdom. No previous studies have been identified in the literature regarding the sun exposure behaviours among secondary care medical professionals.

Doctors were invited to participate in an anonymous questionnaire, which was available both in written and online format. 163 medical professionals completed the questionnaire. A third of doctors demonstrated sun-seeking behaviours and over 10% of medical professionals use tanning beds. Incidences of sunburn (more than 1 episode per year) was rated the highest amongst women, but interestingly female doctors also reported more frequent sun-protective behaviours compared to their male colleagues. More than 65% of medical professionals have never performed skin self-examination or had their skin examined by another healthcare professional.

Our findings illustrate that doctors engage in multiple skin cancer risk behaviours. A comprehensive approach to change behaviour requires exploration of attitudes and sun education should be highlighted among medical professionals and promoted within healthcare system.

About the BAD

 

The British Association of Dermatologists (BAD) is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease. The BAD provides free patient information on skin diseases and runs a number of high profile campaigns, including Sun Awareness, which runs from May to September annually and includes national Sun Awareness Week in May. Website: www.bad.org.uk/sunawareness

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Skin cancer hospital admissions soar by 41% in just five years

Embargo to: 00.01hrs on 02.09.2014

The number of hospital admissions for skin cancer treatment in England has increased by 41 per cent in the space of just five years, according to a study being presented this week at the World Congress on Cancers of the Skin in Edinburgh, Scotland (September 3rd to 6th).

According to the study conducted by researchers at Public Health England, figures rose significantly from 87,685 admissions in English hospitals in 2007 to 123,808 in 2011. This study does not include treatment in outpatients units or by GPs.

Skin cancers are the most common form of cancer in England, with numbers of skin cancers equal to all other types of cancers combined. Whilst skin cancers can be serious, they are also largely preventable as excess sun exposure is a major avoidable cause. In spite of this, this study has revealed a 30 per cent increase in admissions for melanoma treatment, the most serious type of skin cancer, in English hospitals over the five-year period, in an addition to a 43 per cent increase in non-melanoma skin cancer admissions.

The surge in incidence rates has resulted in an annual spend of over £95 million on inpatient skin cancer care, with the most common procedure for both melanoma and non-melanoma skin cancers being surgical excision.

Johnathon Major of the British Association of Dermatologists commented: “As holidays to sunny locations become cheaper and tanned skin remains a desirable fashion statement, we have seen an inevitable increase in skin cancer incidence rates and the associated health and financial burden they place on the nation. Skin cancers are largely preventable and more must be done to communicate to the public the serious risks associated with unmediated sun exposure if we are to see a decline in these figures.”

Julia Verne, Director of the South West Knowledge and Intelligence Team, Public Health England added: “The number of procedures required to meet the demands are increasing at a significant rate. Surgery was required for 78 per cent of non-melanoma skin cancers and 71.5 per cent of melanomas. Over 16,000 skin grafts and flaps were required for the treatment of skin cancer in 2011 and the majority are on the head and neck.

Ends-

Notes to editors:

For more information please contact: Matt Gass, Communications Officer, on 020 7391 6084 or at matthew.gass@bad.org.uk

If using this study, please ensure you mention that the study was released at the World Congress on Cancers of the Skin.  

The conference will be held in Edinburgh from September 3rd to 6th 2014, and is attended by approximately 1,000 UK and worldwide health professionals.

The World Congress on Cancers of the Skin 2014 was founded by The Skin Cancer Foundation, the international organization devoted solely to education, prevention, early detection, and prompt treatment of the world’s most common cancer. It is organised by the British Association of Dermatologists.

 

Study details:
Skin cancer care in England; V.Poirier, T.Jones, A.Ives, J. Newton-Bishop and J.Verne
Background:
Skin cancers – Non Melanoma Skin Cancer (NMSC) and Malignant Melanoma (MM) are the most common cancers in England. The treatment and consequent cost related to NMSC is often considered insignificant compared to MM. We considered the trends in numbers of day case and inpatient treatments for skin cancer during a five year period in England, including procedures used, specialties involved and costs.
Method:
Details of admissions between 2007 and 2011 for a diagnosis of skin cancer (ICD 10 code C43 or C44) were extracted from the inpatient hospital episode statistics (HES). We identified the procedures used and the specialties involved. Healthcare Resources Group (HRG) codes were used to estimate the costs involved. NMSC admissions were matched to the National Cancer Data Repository to determine their morphology: Squamous Cell Carcinoma (SCC) or Basal Cell Carcinoma (BCC).
Results:
There has been a significant increase in hospital admissions between 2007 and 2011 for NMSC (76,528 vs. 109,333) and MM (11,157 vs. 14,475).The main procedures recorded in 2011 were surgical excisions both for NMSC (78%) and MM (71.5%). Moh’s surgery was mainly undertaken for BCC. Over 16,000 flaps and grafts were undertaken for NMSC in 2011 compared to 1,766 for MM. There was some use of amputation for MM and SCC. Most day cases were managed by Dermatologists and Plastic Surgeons and the latter represented the main specialty involved with inpatient care. Dermatologists’ involvement with day cases increased between 2007 and 2011 (3.9% for NMSC and 5.3% for MM) but decreased for Plastic Surgeons (-3.3% and -5.9%). The overall cost of inpatient treatment in England in 2011, based on our data, was £81,114,834 for NMSC and £14,355,797 for MM.

About the BAD

 

The British Association of Dermatologists (BAD) is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease. The BAD provides free patient information on skin diseases and runs a number of high profile campaigns, including Sun Awareness, which runs from May to September annually and includes national Sun Awareness Week in May. Website: www.bad.org.uk/sunawareness

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Incidence of skin cancer on the rise in Scotland once more
CORRECTION: It has come to our attention that the study outlined in the press release below, contained inaccurate data when originally released on August 28th. The amended version is below. 
 

 

Despite a recent decline in Scotland of skin cancer, the UK’s most common cancer is once more on the rise, according to a study being presented at the World Congress of Cancers of the Skin this week in Edinburgh (September 3rd-6th).

The researchers, from the Alan Lyell Centre for Dermatology in Glasgow, analysed data on skin cancer incidence and survival from the Information Services Division (ISD) Scotland. The data showed that the incidence of melanoma and non-melanoma skin cancer has increased 273 per cent (two and half fold) since 1990.

Between 2009 and 2010 there was a one per cent fall in the incidence rate for skin cancer, however this subsequently increased in 2011 above the previous highest recording.

There are three main types of skin cancer. Melanoma is the least common but most deadly form. Squamous cell carcinoma is the second most common type, and together with basal cell carcinoma – the most common but least dangerous form – is known as non-melanoma skin cancer. Of the three skin cancer types, the following increases were noted between 1990 and 2011:

·         Basal cell carcinoma rose from 2910 cases across all age groups in 1990, to 7553 cases in 2011, equal to a rise in incidence of 160%.

·         Squamous cell carcinoma rose from 892 cases in 1990, to 2982 cases in 2011, equating to rise in incidence of 234%.  

·         Cutaneous melanoma increased from 495 cases in 1990 to 1202 cases in 2011, a rise of 143%.

The researchers were also able to report some positive trends, with survival rates soaring over the last 30 years, probably due to better public health messaging on the importance of early detection of skin cancer. Survival at five years after diagnosis between 1983 and 1987 was 64 per cent for men and 81.9 per cent for women. This had increased to 85.4 per cent and 91.7 per cent for males and females respectively for the period 2003 to 2007.

Dr Gregory Parkins, one of the authors of the study, said: ““There are several factors which are likely to be contributing to this increase in skin cancer in Scotland, including more affordable holidays to sunny destinations, sunbed usage, and an aging population.

“It will come as no surprise to the people of Scotland that a large proportion of us have pale skin, which makes the risk of developing skin cancer higher. This means that education around skin cancer and sun protection is hugely important.

Matthew Gass of the British Association of Dermatologists said: “The incidence of melanoma and non-melanoma skin cancer continues to rise at a worrying rate, and although the rise in incidence has been met by an improvement in survival rates, the ultimate goal is to prevent skin cancers occurring in the first place. There is still a long way to go in terms of education around sun awareness and skin cancer. We hope that people recognise that prevention is far better than a cure.”

-Ends-

Notes to editors:

For more information please contact: Matt Gass, Communications Officer, on 020 7391 6084 or at matthew.gass@bad.org.uk

If using this study, please ensure you mention that the study was released at the World Congress on Cancers of the Skin. 

The conference will be held in Edinburgh from September 3rd to 6th 2014, and is attended by approximately 1,000 UK and worldwide health professionals.

The World Congress on Cancers of the Skin 2014 was founded by The Skin Cancer Foundation, the international organization devoted solely to education, prevention, early detection, and prompt treatment of the world’s most common cancer. It is organised by the British Association of Dermatologists.

Study details:

Incidence of Skin cancer within the Scottish Population, Gregory Parkins, Allan Matthews, Grant Wylie; Alan Lyell Centre for Dermatology, Glasgow, UK

Skin type, ultra violet radiation and genetics all play a role in the development of melanoma and non-melanoma skin cancers. With a large number of the population in Scotland having Fitzpatricks type I &II skin, the risk of developing skin cancer is higher. Our aim was to assess the general trends in skin cancer incidence within Scotland. We sourced data on melanoma and non-melanoma skin cancers from the Information Services Division (ISD) Scotland which had figures for skin cancer incidence and survival. We specifically looked at trends in the incidence of melanoma, basal cell carcinoma and squamous cell carcinoma. The incidence of melanoma and non-melanoma skin cancer has increased. The number of cases of basal cell carcinoma rose from 2910 cases across all age groups in 1990, to 7553 cases in 2011, equal to a rise in incidence of 160%. A similar picture was seen with squamous cell carcinoma with 892 cases in 1990, rising to 2982 cases in 2011, equating to rise in incidence of 234%. The number of cases of cutaneous melanoma increased from 495 cases in 1990 to 1202 cases in 2011, a rise of 143%. It was noted between 2009 and 2010 the rates of melanoma and non-melanoma skin cancer fell by 1%, but subsequently increased in 2011 to above the previous highest recording. The relative survival at five years after diagnosis between 1983 and 1987 was 64% and 81.9% for males and females respectively. This had increased to 85.4% and 91.7% for males and females respectively for the period 2003-2007. Incidence of melanoma and non-melanoma skin cancer has risen exponentially. Increasing age and exposure to UV radiation through holidays abroad and sun beds play a role in the trends seen. The levelling off incidence in recent years may reflect a plateau in skin cancer rates. It is encouraging however, that the rise in incidence has been met with improvement in survival from melanoma, especially amongst males who have shown an absolute increase in survival of 21% over 20 years. Given the management of melanoma has not really changed in this time, the improved survival may be a result of public health messages specifically on sun protection and the importance of early detection of skin cancer.

Reference: ISD Information Services Division, NHS National Services Scotland, Cancer Statistics, Skin Cancer.

About the BAD

The British Association of Dermatologists (BAD) is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease. The BAD provides free patient information on skin diseases and runs a number of high profile campaigns, including Sun Awareness, which runs from May to September annually and includes national Sun Awareness Week in May. Website: www.bad.org.uk/sunawareness

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